Trial reportGut2022
Diet or medication in primary care patients with IBS: the DOMINO study - a randomised trial supported by the Belgian Health Care Knowledge Centre (KCE Trials Programme) and the Rome Foundation Research Institute.
Trial report in Gut, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04270487 (A Randomized Controlled Trial to Evaluate the Short-term Efficacy and Long-term Health Economic Impact of a Dietary Intervention Compared to Pharmacotherapy With a Musculotropic Spasmolytic Agent for Newly Diagnosed or Newly Treated Irritable Bowel Syndrome in Primary Care), which is not on this map. Cited by 30 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Randomized Controlled Trial to Evaluate the Short-term Efficacy and Long-term Health Economic Impact of a Dietary Intervention Compared to Pharmacotherapy With a Musculotropic Spasmolytic Agent for Newly Diagnosed or Newly Treated Irritable Bowel Syndrome in Primary Care
Who cites it
30 citing papers in PubMed, 60 citations in OpenAlex.
- Trial
- A study on the utility of inflammatory biomarkers in primary care irritable bowel syndrome: a sub analysis of the DOMINO randomized trial.BMC gastroenterology · 2025Trial
- The Potential of Complementary and Alternative Therapies in Improving Diarrhea-Predominant Irritable Bowel Syndrome: Strategies for Long-Term Efficacy.Digestive diseases and sciences · 2026Review
- Disordered Eating Behaviors Many Years After Education in a Low FODMAP Diet in Patients With Irritable Bowel Syndrome.JGH open : an open access journal of gastroenterology and hepatology · 2026Article
- Internet-delivered cognitive behavioral therapy and FODMAP diet for adults with irritable bowel syndrome: A four-arm randomized controlled trial.Internet interventions · 2026Article
- Nutritional Management of Irritable Bowel Syndrome.Nutrients · 2026Review
- Translation, cross-cultural adaptation and validation of the Chinese version of irritable bowel syndrome severity scoring system.Frontiers in medicine · 2026Article
- Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols Reintroduction in Clinical Practice: Surveying the Gaps and Opportunities.Gastro hep advances · 2026Article
- Expert Opinion on the Efficacy and Safety of Antispasmodics with a Focus on Irritable Bowel Syndrome.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2025Review
- Implementing a Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols Diet in Asia: Addressing Cultural, Clinical and Practical Challenges.Journal of neurogastroenterology and motility · 2025Review
- Repurposing 1,4-Dihydropyridine Scaffold: 4-Imidazo[2,1-Pharmaceuticals (Basel, Switzerland) · 2025Article
- Mesenchymal stem cell-derived apoptotic vesicles regulate irritable bowel syndrome in mice via the 5-HT brain-gut axis.Stem cell research & therapy · 2025Article
- The Duodenal Microenvironment in Functional Dyspepsia.Journal of neurogastroenterology and motility · 2025Review
- [Dietary Therapy in Irritable Bowel Syndrome].The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi · 2025Review
- A Systems Biology and Drug Repositioning Approach for the Analysis of Mutual Genes Between Celiac Disease and Irritable Bowel Syndrome.BioMed research international · 2025Article
- Modification of the Low FODMAP Diet Is Feasible in the Treatment of Irritable Bowel Syndrome: A Randomised Crossover Study.Gastroenterology research and practice · 2025Article
- Dietary management of irritable bowel syndrome: considerations, challenges, and solutions.The lancet. Gastroenterology & hepatology · 2024Review
- Gut-Brain Axis and Psychopathology: Exploring the Impact of Diet with a Focus on the Low-FODMAP Approach.Nutrients · 2024Review
- The Role of the FODMAP Diet in IBS.Nutrients · 2024Review
- DOMINO trialTherapeutic advances in gastroenterology · 2024Article
Corrections and comments
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Authors and funding
27 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn Europe, IBS is commonly treated with musculotropic spasmolytics (eg, otilonium bromide, OB). In tertiary care, a low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet provides significant improvement. Yet, dietary treatment remains to be explored in primary care. We evaluated the effect of a smartphone FODMAP-lowering diet application versus OB on symptoms in primary care IBS.
methodsIBS patients, recruited by primary care physicians, were randomised to 8 weeks of OB (40 mg three times a day) or diet and followed for 24 weeks. We compared IBS Symptom Severity Score and the proportion of responders (improvement ≥50 points) in all patients and the subgroup fulfilling Rome IV criteria (Rome+). We also evaluated treatment efficacy, quality of life, anxiety, depression, somatic symptom severity (Patient Health Questionnaire (PHQ15, PHQ9)) and treatment adherence and analysed predictors of response.
results459 primary care IBS patients (41±15 years, 76% female, 70% Rome+) were randomised. The responder rate after 8 weeks was significantly higher with diet compared with OB (71% (155/218) vs 61% (133/217), p=0.03) and more pronounced in Rome+ (77% (118/153) vs 62% (98/158), p=0.004). Patients allocated to diet (199/212) were 94% adherent compared with 73% with OB (148/202) (p<0.001). The significantly higher response rate with diet was already observed after 4 weeks (62% (132/213) vs 51% (110/215), p=0.02) and a high symptom response persisted during follow-up. Predictors of response were female gender (OR=2.08, p=0.04) for diet and PHQ15 (OR=1.10, p=0.02) for OB.
conclusionIn primary care IBS patients, a FODMAP-lowering diet application was superior to a spasmolytic agent in improving IBS symptoms. A FODMAP-lowering diet should be considered the first-line treatment for IBS in primary care. TRIAL REGISTRATION NUMBER: NCT04270487.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.